Individual
LYNNELLE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
457 S FITNESS PL, EAGLE, ID 83616-6568
(208) 856-0564
Mailing address
PO BOX 2681, EAGLE, ID 83616-9122
(208) 856-0564
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-67377
ID
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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